
<div class="inner-message">
    {php extract(dr_get_form_post_value('zxly'))}
    <div class="th">{usu_fanyi('Mail consultation', $language)}</div>
    <div class="inner-message-centered">{usu_fanyi('Please feel free to give your inquiry in the form below.', $language)}<span>
      {usu_fanyi('We will reply you in 24 hours.', $language)}</span></div>
    <div class="inner-message-row">
      <form method="post" name="myform" id="myform">
        <div class="item item-half">
          <div class="inner-message-half">
            <input type="text" class="input-lg form-full" value="{usu_fanyi('Title', $language)}"
              name="data[biaoti]" id="data[biaoti]" required="">
          </div>
        </div>
        <div class="item item-half">
          <div class="inner-message-half">
            <input type="text" class="input-lg form-full" value="*{usu_fanyi('Name', $language)}"
              name="data[xingming]" id="data[xingming]" required="">
          </div>
        </div>
        <div class="item item-half">
          <div class="inner-message-half">
            <input type="text" class="input-lg form-full" value="{usu_fanyi('Phone', $language)}"
              name="data[lxdh]" id="data[lxdh]" required="">
          </div>
        </div>
        <div class="item item-half">
          <div class="inner-message-half">
            <input type="text" class="input-lg form-full" value="*{usu_fanyi('Email', $language)}"
              name="data[dzyx]" id="data[dzyx]" required="">
          </div>
        </div>
        <div class="item">
          <div class="inner-message-box">
            <input type="text" class="input-lg form-full" value="{usu_fanyi('Address', $language)}"
              name="data[lianxidizhi]" id="data[lianxidizhi]" required="">
          </div>
        </div>
        <div class="item">
          <div class="inner-message-box">
            <textarea value="Message"
              name="data[lynr]" id="data[lynr]" class="form-full" required="">*{usu_fanyi('Message', $language)}</textarea>
          </div>
        </div>
        <div class="item item-half">
          <div class="inner-message-half">
            <input type="text" class="input-lg form-full" value="*Code"
              name="code" id="code" required="">
          </div>
        </div>
        <img align="absmiddle" style="cursor:pointer; margin-left: 10px;"
        onclick="this.src='/index.php?s=api&amp;c=api&amp;m=captcha&amp;width=120&amp;height=35&amp;'+Math.random();"
        src="/index.php?s=api&amp;c=api&amp;m=captcha&amp;width=120&amp;height=35&amp;0.03476318342132978">
        <div class="item">
          <button type="button" class="btn-text" onclick="dr_ajax_submit('{$post_url}', 'myform', '2000', '{$rt_url}')">{usu_fanyi('Submit', $language)}</button>
        </div>
      </form>
    </div>
  </div>